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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Texas rates for HCPCS A4100

Nonsheet form skin substitute, FDA-cleared as a device, not otherwise specified (list in addition to primary procedure)

Rates data updated October 2026.

How much does Nonsheet Skin Substitute, FDA-Cleared, Unclassified cost?

$102

Typical negotiated rate. In Texas, October 2026.

Insurers have agreed to pay about $102 for this service. The price depends on where it is billed: about $102 from a physician practice, and about $240 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$102$102 to $661
FacilityA hospital or hospital-owned outpatient department$240$186 to $407

How much rates vary

Facilitymedian $240 · 10th to 90th $155 to $617Professionalmedian $102 · 10th to 90th $93 to $1,096
$100$200$500$1Kfacility $240professional $102

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$109.65
Aetna
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$95.50
Typical High
$109.65
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$41.69
Median
$47.86
Typical High
$54.95
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$16.60
Median
$19.05
Typical High
$21.88
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$12.59
Median
$14.13
Typical High
$16.22
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.32
Median
$9.55
Typical High
$10.96
BCBS Texas
Setting
Facility
Modifier
None
Typical Low
$181.97
Median
$263.03
Typical High
$616.60
Cigna
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$660.69
Median
$1,096.48
Typical High
$1,096.48
Moda Health
Setting
Facility
Modifier
None
Typical Low
$93.33
Median
$120.23
Typical High
$154.88
Moda Health
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$95.50
Typical High
$117.49
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$41.69
Median
$47.86
Typical High
$54.95
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$16.98
Median
$19.05
Typical High
$21.88
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$12.59
Median
$14.13
Typical High
$16.22
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.51
Median
$9.55
Typical High
$10.96
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$302.00
Providence
Setting
Facility
Modifier
None
Typical Low
$93.33
Median
$125.89
Typical High
$154.88
Providence
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Texas sits

The same service costs 83.2 times more in North Dakota than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Texas· 36th of 51

$102

ND $251KS $3.02

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.